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Director, PBM Specialty Pharmacy Network Contracting
Navitus Health SolutionsDirector leading specialty pharmacy network contracting negotiations and management. Focused on ensuring competitive contract terms within Navitus's healthcare framework.
About the role
Key responsibilities & impact- Lead negotiation of specialty pharmacy participation agreements across all provider segments, including national chains with specialty capabilities, independent specialty pharmacies, and health system–affiliated providers.
- Own reimbursement structures, contract terms, and financial outcomes for specialty pharmacy agreements, including high-cost drug categories.
- Establish negotiation strategies that balance market competitiveness, provider sustainability, and enterprise financial objectives within the specialty drug landscape.
- Serve as the decision-maker for contract structure, rate positioning, and escalated negotiation decisions.
- Approve contract exceptions and ensure alignment to broader specialty network and enterprise strategy.
- Provide strategic leadership over specialty pharmacy participation agreements, network addenda, and contract standards, ensuring consistency with enterprise pricing, access, and compliance objectives.
- Develop and maintain contracting playbooks, standards, and governance frameworks to support scalable and consistent negotiation practices.
- Guide contract structure decisions to support evolving pricing strategies, regulatory changes, and market dynamics.
- Recommend enhancements to contract language and structure to improve clarity, enforceability, and long-term sustainability.
- Lead specialty provider engagement strategy to support successful contract negotiations, alignment to contract intent, and long-term network stability.
Requirements
What you’ll need- Bachelor’s degree in Business, Finance, Economics, or Healthcare Administration, or related field, or equivalent work experience, required.
- 7+ years of progressive PBM, healthcare plan, pharmacy network, or equivalent experience required.
- Demonstrated experience in provider contracting, contract strategy, or network governance required.
- Strong understanding of pharmacy reimbursement and claims adjudication concepts required.
- 3+ years of leadership experience with a proven ability to develop high-performing teams and deliver tangible results in a professional services environment required.
- Participate in, adhere to, and support compliance program objectives.
- The ability to consistently interact cooperatively and respectfully with other employees.
Benefits
Comp & perks- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
provider contractingcontract strategynetwork governancepharmacy reimbursementclaims adjudicationnegotiation strategiescontract structurecontract language enhancementfinancial outcomes managementcontracting playbooks development
Soft Skills
strategic leadershipteam developmentinterpersonal communicationcooperative interactiondecision-makingnegotiationalignment to contract intentlong-term stability focusmarket competitiveness balanceprovider sustainability focus